Addiction expert Reinout Wiers: ‘The mind often wins, but not always’

25 February 2020

Our trainees Maria and Mink, both aged fourteen, talked to brain researcher Reinout Wiers about his discoveries relating to addiction. He learned that automatic processes in the brain play an important role, and that you can overcome them.

Trainees Mink and Maria with Reinout Wiers

What is your research about?

‘I do research into addiction in the broad sense. The most common addictions are to alcohol, smoking and cannabis. But at the UvA we also look at things like gambling addiction and addiction to your phone. What changes take place in the brain when someone is addicted and how can we help people to overcome these problems? These are the key questions in our research.’

Why do you find addiction an interesting subject? Do you have personal experience with this?

‘During my doctoral research project, which was about children of alcoholics, journalists always wanted to know whether I had personal experience with this. After a while I sometimes joked ‘of course’, but actually no. I’m fascinated by the relationship between body and mind. We’re constantly doing things that we don’t really understand and that are bad for us. You can see this in addiction, too. Why is this? Sometimes the mind wins, but not always.’

What have you already found out about addiction?

‘Automatic processes play an important role in addiction, and you can overcome these processes. If we look at drinking, for instance, people often associate drinking alcohol with a certain situation or feeling. When you come home from work, you drink a glass of wine to relax, or when you’re at a party you have a drink because it’s nice and sociable. You can decide for yourself not to drink any more, but the associations trigger an automatic process which will still push you towards that drink without you consciously thinking about it.’

‘In our research we see whether you can influence these automatic processes. Can we tackle the associations and in this way change your behaviour, such as drinking less? We have developed a method for teaching people new and negative associations in relation to their addiction. To give one example, people had to push a joystick away or pull it towards them when they saw certain images. By learning to physically push something away, after a while they learned to push it away in their head as well. In this way we established an automatic link between the addiction agent and ‘pushing away’, which created strong negative associations. This method has also been used in treatments.’

How do you get addicted to something?

‘There’s a lot of discussion about this. It’s often said that addiction is a chronic brain disease. And it’s true that things change in the brains of people who are addicted, but there are also people who can still stop after a 10-year addiction, such as smoking. That isn’t actually possible in the case of a chronic brain disease. Dementia is one example of such a disease – that’s something you can never be cured of.’

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Addiction is fifty percent genetically determined, but is also linked to personality, impulsiveness and the desire for sensation

‘We know that addiction is fifty percent genetically determined. However, these genes only take effect when you begin, for instance by smoking a cigarette or drinking alcohol. But addiction is also linked to personality, impulsiveness and the desire for sensation. This last factor is particularly strong when it comes to young men. And wanting to get away from negative feelings plays a role too, when things happen like losing your job or going through a divorce. Problems like these can push you off the rails.’

How can you overcome addictions?

‘The key thing for overcoming an addiction is motivation. But this doesn’t mean that people who have difficulty overcoming an addiction aren’t really motivated. It’s also about finding a good combination of strategy, technique and therapy. To give one example, in our research we’ve seen that if people receive training then ten percent fewer relapse into their addiction after a period of one year.’

Does age make a difference regarding the susceptibility to addictions?

‘You see that people who started smoking before the age of twenty have more difficulty quitting than people who started later. If they start earlier, there are bigger changes in the brain. It’s much easier for young people aged sixteen or seventeen to stop, for instance. But the thing is that young people of this age usually don’t see it as a problem, and so they have no motivation at all to stop. So in our research we are also focussing specifically on young people, and we’re visiting schools for instance.’

Do you have any advice about how to prevent addiction?

‘Since the genes relating to addiction become active the first time you come into contact with something addictive, then of course it’s best to begin something like drinking as late as possible. When you consider this, the discussion about legalisation becomes very tricky. Legalisation may be a good idea for preventing crime. But it’s not good for preventing addiction, because then young people get easy access to cannabis.’

‘You can see that legal age limits do have an effect. In America you’re not allowed to drink until you reach the age of twenty-one, and almost no-one drinks under the age of eighteen. In the Netherlands you’re not allowed to drink until you reach the age of eighteen, and you can see that there’s been a huge increase in the number of people aged under sixteen who don’t drink. So you could argue for an age limit of twenty-one, just like in America, but I’m not sure if that could be enforced.’

‘Finally, we see that children of alcoholics are often more susceptible to alcohol in genetic terms. So drinking nothing at all would be the best option for them, but that’s really very difficult precisely because they are often in an environment where alcohol is always present.’

How many people have one or more addictions?

‘In the Netherlands, one in three men have been addicted during some period of their life. In this case, this refers to experiencing loss of control due to drinking, or continuing to drink despite physical problems. It’s not about the quantity, but about compulsion: the unconscious urge to keep on drinking no matter what.’

Do you also treat addiction?

‘We’re always working to translate our research results into therapies and treatments so that therapists can make use of them. And we also offer our own training programmes through Adaptlab, as it’s called. This has programmes for addiction, but also for learning to deal with anxiety. Fear of maths in girls, for instance. In our culture girls learn to identify less with science subjects, which can lead to a negative self-image when it comes to maths. We can see this reflected in the CITO scores, where girls score lower in structural terms. In our training programme we try to remove this negative association.’

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